Provider Demographics
NPI:1306819552
Name:PATEL, MUKESH (PA)
Entity Type:Individual
Prefix:
First Name:MUKESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 MEDICAL CENTER DR
Mailing Address - Street 2:STE 500
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-4024
Mailing Address - Country:US
Mailing Address - Phone:661-381-7222
Mailing Address - Fax:
Practice Address - Street 1:8307 BRIMHALL RD STE 1706
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-4343
Practice Address - Country:US
Practice Address - Phone:661-903-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17358363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ13009Medicare UPIN